• Childhood Kidney Diseases
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• 제16권1호
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• pp.21-31
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• 2012

초점성 분절성 사구체 경화증(focal segmental glomerulosclerosis; FSGS)은 경화증을 주 병변으로 하는 질환으로서 일차성 사구체 질환의 하나이면서 진행된 사구체 질환의 형태적 변화를 기술하는 단어로도 사용되고 있다. 사구체에는 경화증, 유리질 형성, 거품세포의 출현, 발세포의 공포화, 광륜형성 등이 보이고, 간질의 섬유화와 염증세포의 침윤, 세뇨관의 위축, 혈관의 비후 및 내막 섬유화 등을 특징으로 한다. 면역형광검사에서 부분적으로 IgM과 C3 등의 침착을 보이지만 면역관련 질환은 아니다. 전자현미경 검사에서는 발세포의 손상 현상으로 세포질 내의 공포화와 족돌기가 상실되는 것이 중요 소견이다. 2004년 표준화 된 FSGS의 분류는 과거의 형태학적 변형들을 모아서 임상과의 상관관계를 지웠다. 그 결과 tip형이 가장 예후가 좋으며, collapsing형이 가장 나쁜 것으로 알려졌다. 그러나 이 분류가 증례에 따라서는 적용하기가 애매한 경우가 많고, collapsing형을 FSGS에 분류하는 것에 대한 반론 등이 제기되고 있다. 한편, 임상적으로는 FSGS를 원인에 따라 분류하여 거꾸로 형태학적 공통점을 찾으려는 노력을 하고 있다. 사구체의 수가 적어서 일어나는 과여과로 인한 FSGS는 perihilar형이 많고 유전적 질환에 의한 것은 diffuse mesangial sclerosis가 특징인 것으로 주장되고 있다. FSGS는 이와 같이 아직도 밝혀져야 할 것이 많은 질환이며, 계속적인 연구가 이루어져야 할 필요가 있다.

• 한국임상수의학회지
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• 제32권5호
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• pp.445-448
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• 2015

5개월령 코리안 숏헤어 새끼 고양이(몸무게 1.7 kg)가 상부호흡기 증상, 얼굴과 발/발바닥의 궤양과 부종 및 파행을 주증으로 내원하였다. 실험실 검사상, 백혈구감소증, 림프구 감소증, 췌장염 및 칼리시바이러스 감염증이 확인되었다. 진단은 고독성 칼리시바이러스 감염증에 대한 특이 임상증상과 PCR을 통한 칼리시바이러스 동정 및 다른 상부호흡기 감염을 배제함으로써 내려졌다. 상부호흡기 증상완화와 이차 감염에 대한 처치 및 보조요법을 약 한 달간 실시하였고, 환자는 이러한 치료를 통해 임상증상이 크게 개선되었다. 본 증례는 고독성 고양이 칼리시바이러스에 대한 첫 번째 발병증례이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권2호
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• pp.121-131
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• 2020

Purpose: To determine the long-term efficacy of the anti-tumor necrosis factor (TNF) agents, infliximab (IFX) and adalimumab (ADA), in pediatric luminal Crohn's disease (CD) by performing a systematic literature review. Methods: An electronic search was performed in Medline, Embase, and the Cochrane Library from inception to September 26, 2019. Eligible studies were cohort studies with observation periods that exceeded 1 year. Studies that reported time-to-event analyses were included. Events were defined as discontinuation of anti-TNF therapy for secondary loss of response. We extracted the probabilities of continuing anti-TNF therapy 1, 2, and 3 years after initiation. Results: In total, 2,464 papers were screened, 94 were selected for full text review, and 13 studies (11 on IFX, 2 on ADA) met our eligibility criteria for inclusion. After 1 year, 83-97% of patients were still receiving IFX therapy. After 2 and 3 years the probability of continuing IFX therapy decreased to 67-91% and 61-85%, respectively. In total, 5 of the 11 studies subgrouped by concomitant medication consistently showed that the probabilities of continuing IFX therapy in patients with prolonged immunomodulator use were higher than those in patients on IFX monotherapy. Conclusion: This review of real-world evidence studies confirms the long-term therapeutic benefit of IFX therapy in diverse cohorts of children with luminal CD. Moreover, it supports the view that combination therapy with an immunomodulator prolongs the durability of IFX therapy in patients who previously failed to recover following first-line therapy. The limited number of time-to-event studies in patients on ADA prevented us from drawing definite conclusions about its long-term efficacy.

• Journal of Preventive Medicine and Public Health
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• 제50권5호
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• pp.294-302
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• 2017

Objectives: The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Methods: Data from self-reported questionnaires that assessed an individual's history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Results: Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of selfreported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Conclusions: Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

• 식물병연구
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• 제10권3호
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• pp.183-187
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• 2004

2002년 경남 창원시 동읍 단감 저온 저장고에 저장중인 과실에서 검은점무의 증상이 심하게 발생하였다. 병징은 과실표면에 검은색 둥근 반점이 생기고 병반부위가 확대되면서 그 위에 암갈색의 곰팡이를 형성한다. 병반부위를 절단해 보면 감염된 표피에서부터 시작하여 과육내부까지 갈색으로 변색되고 스폰지 모양으로 부패되어 상품성이 전혀 없다. 병원균의 분생포자는 난형, 곤봉형, 서양배형이고 드물게 타원형도 있으며 횡격막이 3∼5개, 종격막이 1∼2개 있다. 색깔은 연한 갈색 또는 금색을 띄는 갈색이고 크기는 12∼46${\times}$6∼12$\mu\textrm{m}$이었다. 분생포자경은 연한 담갈색이고, 크기는 42∼95${\times}$3∼5 $\mu\textrm{m}$이었다. 균사생육적온은 25∼3$0^{\circ}C$이었다. 단감 저장중 과실에 발생한 병징과 병원균의 균학적 특징을 조사한 결과, 이 병을 Alternaria alternata (Fr.) Keissler에 의한 단감 검은점무의병으로 명명하고자 제안한다.

• The Plant Pathology Journal
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• 제28권3호
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• pp.317-321
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• 2012

Plants are the promising reservoirs for natural products with their diverse secondary metabolites. Many invasive plants have been introduced in Korea, which adversely affect on the native ecosystem but holds difficulty removing them due to their proliferation. In this study, we evaluated disease control efficacy of methanol extracts from four invasive plant species against 7 representative crop pathogens. Methanol extract of Phytolacca americana effectively suppressed rice blast, tomato gray mold, and tomato late blight in a dose dependent manner. The methanol extract of Amorpha fruticosa also exhibited potent antifungal activity against pepper anthracnose in a concentration dependent way. These data suggest that the extracts of P. americana and A. fruticosa can be developed as plant disease protection agents against rice blast, tomato gray mold, tomato late blight, and pepper anthracnose. Furthermore, more extensive research will be required to identify and isolate active compounds from problematic invasive plant species to develop valuable agrochemicals.

• 식물병연구
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• 제19권4호
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• pp.300-307
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• 2013

This study was conducted to determine the occurrence of leaf rot and leaf ring spot, caused by Rhizoctonia solani in Chinese cabbage under seedling nursery and cultivation greenhouses. Symptoms of leaf rot and leaf ring spot were found in three Chinese cabbage cultivars, Brassica campestris subsp. pekinensis, 'Ryeokgwang', 'Daetong', and 'CR mat'. In Hwacheon, the disease incidence was 73.8% in the seedling stage of the Chinese cabbage. In Icheon, the symptoms were observed on the upper leaves of the Chinese cabbage cultivar, 'Norangmini' with 20.5% of disease incidence. The symptoms appeared as primary lesions consisting of small, circular necrotic ring spots with gray color, 1.4-3.0 mm in diameter, accompanied by secondary rot lesions with large irregular borders of leaves. The color of mycelial mat of 20 isolates was dark brown and light brown. The average hyphal diameter of all the isolates was within 5.01-11.12 ${\mu}m$. Among the 20 strains isolated from Chinese cabbage, 16 isolates and four isolates anastomosed with the AG-1 (IB) and AG-1 (IC), respectively. Twenty isolates tested were only virulent on foliage parts of Chinese cabbage leaves but were avirulent on stem parts of the plants. Based on the mycological characteristics and pathogenicity test on host plants, the fungus was identified as Rhizoctonia solani.

• 한국융합학회논문지
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• 제8권5호
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• pp.127-135
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• 2017

본 연구는 세종특별자치시 동, 면 거주자의 만성질환 진단율과 영향요인을 확인하기 위해 조사되었다. 2013-2015년 지역사회 건강조사 자료를 활용한 2차 분석 연구로 총 1,067명의 자료가 이용되었고 위계적 로지스틱 회귀분석을 이용하여 분석하였다. 분석결과, 동 지역 거주자는 만성질환 진단을 받을 확률이 여자보다 남자가 7.34배 높았고, 걷기 일수가 3일 미만인 군이 3일 이상인 군에 비해 2.20배 높았다. 면 지역 거주자는 비 흡연 군 보다 흡연 군이 1.19배 높은 것으로 나타났다. 연구결과, 동지역 거주자와 면지역 거주자에게 차별화된 만성질환 예방건강관리 프로그램 개발이 필요한 것으로 확인되었다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권3호
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• pp.180-186
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• 2015

Purpose: Bile duct dilatation is a relatively common sonographic finding; nevertheless, its clinical significance in children is controversial because little research has been done in the area. Therefore, we investigated the natural course and clinical significance of biliary duct dilatation in children. Methods: We performed a retrospective study of 181 children (range, 1-day-old to 17-year-old) in whom dilatation of the intrahepatic duct and/or common hepatic duct and/or common bile duct was detected by abdominal ultrasonography at the Severance Children's Hospital between November 2005 and March 2014. We reviewed and analyzed laboratory test results, clinical manifestations, and clinical course in these patients. Results: Pediatric patients (n=181) were enrolled in the study and divided into two groups. The first group included 59 subjects, without definitive cause of bile duct dilatation, who did not require treatment; the second group included 122 subjects, with definitive cause of bile duct dilatation or underlying biliary disease, who did require treatment. In the first group, 24 patients (40.7%) showed spontaneous resolution of bile duct dilatation, 20 patients (33.9%) showed no change, and 15 patients (25.4%) were lost to follow-up. In the second group, 31 patients were diagnosed with choledochal cysts, and 91 patients presented with biliary tract dilatations due to secondary causes, such as gallbladder or liver disease, post-operative complications, or malignancy. Conclusion: Biliary dilatation in pediatric patients without symptoms, and without laboratory and other sonographic abnormalities, showed a benign clinical course. No pathologic conditions were noted on follow-up ultrasonography.

• Childhood Kidney Diseases
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• 제24권1호
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• pp.47-52
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• 2020

Pneumocystis pneumonia (PCP) is a rare disease in healthy people but a potentially fatal opportunistic infection by Pneumocystis jirovecii in immunocompromised patients with organ transplantation. We present three cases of PCP after kidney transplantation in pediatric patients. First case was a 4-year-old boy diagnosed with Denys-Drash syndrome and received living-donor kidney transplantation from his mother at age of 1. Second case was a 19-year-old male, with polycystic kidney disease, who received kidney transplantation from his mother at the age of 18. Third case was a 19-year-old female with chronic kidney disease of unknown etiology, who received kidney transplantation from her father at age of 15. These three patients who were on immunosuppressive therapy and completed of routine PCP prophylaxis for 6 months had presented with cough and dyspnea more than 1 year after transplantation. Chest x-ray all showed diffuse haziness of both lung fields, and bronchoalveolar lavage from bronchoscopy revealed Pneumocystisjirovecii infection. All patients showed clinical resolution with intravenous trimethoprim-sulfamethoxazole (TMP-SMX) therapy for at least 3 weeks and had continued secondary prophylaxis for another 6-12 months. This report suggests that clinicians should have suspicion for the possibilities of opportunistic infection such as PCP after kidney transplantation in children.